Part 5 – Voices from the Massage Field: Meeting the Challenges of COVID-19

I have practiced massage therapy in a New York City/Long Island metropolitan area hospital for 20 years. We offer massage to walk-in patients with a variety of ailments. We regularly massage hospital staff. We have developed an extensive inpatient and community palliative massage program for patients suffering from long-term illness.

Especially during this particular outbreak, we have been providing chair massage for the entire overstressed staff — everyone, including senior administrators, doctors, nurses, respiratory therapists, environment specialists, security officers, nutritional services staff. Here’s a Q&A I go through daily.

Is it a risk? Of course it is.

Do you consider yourself a health care practitioner? Yes, according to New York state law we are health care practitioners.

Are spas closed? Yes, and your business has then been considered non-essential.

Are hospitals closed? No. All employees must report to work. Contract therapists can choose but unemployment benefits are slow to process for them.

Does our work provide a medical component? Yes, as we are reducing the release of cortisol, assisting their bodies’ immune function, as well as helping staff who are faced with an added emotional component of having to deal with overwhelming loss of life, not to mention the added physical aspect to their job due to turning and repositioning paralyzed, intubated patients. (And, they are all forever thanking us for accepting the risk while supporting them.)

Do we practice the same universal precautions as we would if we were exposed to cancer patients, TB patients, or patients with antibiotic-resistant bugs or influenza? Yes, and then some. We call it universal precautions on overdrive, donning masks, gloves, and using microbial wipes on all equipment touched before, during and after each person is massaged.

I do the research, I listen to my hospital-physician colleagues and government leadership and I rely on that education to make informed decisions. All people on the planet Earth will eventually become infected with, or have already contracted through exposure, this killer disease. Those still not infected are praying for a vaccine. At best we’re looking at two to three years for an effective vaccine.

The purpose of social distancing is not to save you from catching the virus, but rather to keep you from spreading the disease to strangers, family and friends,and the most important reason, to protect our health care system from an all-out collapse due to overcrowding.

Like other community-acquired diseases such as measles, mumps, diphtheria, chickenpox, polio, smallpox, influenza or the common cold, COVID-19 will not be going away, ever. We will learn, through social distancing and extreme hygiene, to live with this disease in our presence.

Go back to basics, folks. Take a deep breath, lift your chin and straighten up your spine. Decide whether you are personally strong enough to continue in your chosen profession. It is completely acceptable if you choose not to continue practicing the art of massage. It is not acceptable to denigrate those of us who have decided to continue to practice and provide our gifts to those who need it.

To those massage therapists who want to continue working, I understand your position. I, too, have been self-employed and I understood the risks (expenses like rent vs. travel, advertising, time to do all the tasks required), and the advantages like being your own boss and deciding when, where and how much money to charge.

These are business models we must consider when approaching massage therapy as a career choice: working as a sole proprietor or in affiliation with a small business or corporate spa as an employee, positions which are admittedly limited. I very much understand the pros and cons of those choices for massage therapists in private practice vs. employee status. It completely comes down to how you choose to file income tax.

I don’t apologize for the responsibilities bestowed upon me. Believe me, I greatly appreciate the direction my path has taken and I do everything in my power to protect and defend, virtuously representing the profession of medical massage therapy with one end goal: inclusion in the national insurance guidelines from HHS and the Office of Medicare/Medicaid, thereby qualifying our profession for accepting all insurance.

While there is a lull in the self-employed massage business, perhaps we can unify to make those changes as a profession instead of quibbling about the inequities of business models and make positive changes in the medical massage therapy profession as a whole.

Loretta M. Dalia, LMT
Years in hospital-based massage: 20
Clinical Coordinator/Supervisor
Stony Brook Southampton Hospital
Southampton, New York

I have been supporting the hospice massage community with continued webinars offering a platform for sharing as well as presenting ways to communicate with clients and sites and presenting concepts of expanded service for helping the families and health care sites with anxiety and depression at this time.

I am navigating through online possibilities for continuing to be an educator and finding ways to stay connected to the hospice massage community in a way that serves the community right now. I am developing protocols for practitioners to stay connected to their health care sites and clients virtually.

I am in the process of submitting an online CE course to the NCBTMB with demonstrations rather than student practice. I have changed my San Francisco course to in-classroom only. No clinical practice for at least a year. I have been offering live Facebook sessions in self-comforting for health care providers. I have scheduled several online classes with caregiver organizations teaching self-touch for comforting and stress reduction. These classes are offered on a donation basis.

Clients are dying without the service hospice massage practitioners are committed to providing. There is a lot of guilt with this. This is a very painful time for the hospice massage community. On the flip side, this is an extremely creative time of exploring ways to use the skills we have in ways we never dreamed of.

I believe it is time to widen the scope of my practice and recognize all the skills that my hands-on practice includes and develop online strategies for teaching families and health care institutions ways of creating comforting environments that soothe the sense of touch. If comforting services, which include families, are not allowed to visit, then environmental adaptations can be cultivated to soothe and comfort through sight, sound, textures and colors.

As a massage practitioner I have the skills or centering, grounding, eye contact, presence through breath, voice tone and listening skills, I can provide virtual touch teachings to families and virtual sessions for clients including soothing dialogues.

Irene Smith, CMT
Years in massage: 46
Owner, educator, Everflowing
San Francisco, California

When talk of the virus and social distancing first began circulating, I went searching on Facebook for massage groups. I posted, “how do we maintain social distancing when our job involves touching people?” The answer was pretty obvious — you don’t. It was good to get the simple reality of that in my head.

My initial reaction was disbelief but the more I thought about it, the more relieved I became. I knew that closing was the only way I could do my part to “flatten the curve.” And because I had recently moved my practice to my home, sharing that space with others suddenly made me feel strangely vulnerable — which made me feel sad.

The biggest initial challenge was definitely the fear around not generating an income. There has never been financial assistance for self-employed before COVID-19. And it was unbearably frustrating trying to work with a system that was, quite simply, not intended for us.

By some miracle I was recently selected to participate in Oregon’s Pandemic Unemployment Assistance “pilot program” — which will eventually provide financial assistance to the self-employed and connect us to the CARES Act. So I have my foot in the door now. Then the very next day I received notice that my stimulus check from the IRS would be mailed on May 1. Yippee!

With the financial fears resolved, tactile withdrawal is my greatest challenge and a major trigger for bouts of depression. The combination of no clients, sheltering alone and the loss of my furry friend shortly before COVID-19 struck has, at times, been debilitating. I have begun taking hikes up to a nearby farm just so I can touch another living creature. The animals seem to sense something is wrong with the two-leggeds — and have been incredibly loving toward me. When the social distancing requirements are lifted you will probably find me on the corner with a FREE HUGS sign. I will definitely have some catching up to do.

I think it is premature to do anything to “build” my practice at this time. I have taken a few online CE courses and stay in touch with my clients via my business’s Facebook page and text messages. I also created a series of stretching and meditation classes my clients can purchase and access online to help them relieve some stress. But I backed away from selling gift certificates because it felt a little too much like going into debt with the future of my business unclear.

All the articles about what the future of our industry may look like are just speculation based on the information at hand. The bottom line is we simply do not know — because we are not there yet. So I decided the only way to maintain my sanity was to step back and look at a much larger picture.

Rather than going on the assumption that I will return to my practice of 33 years, I am opening up my heart and mind to infinite possibilities. There is no rush. I am going to let the decision-making wait until all the facts are in and the reopen date is set. Until then my mantra is: breathe — relax — and let the uncertainty go. When the time comes to make those decisions I trust my heart will show me the right path.

I am thankful to live in Oregon, which has made a pact with Washington and California about what will be required to re-open. Gov. Gavin Newsom has created a list of requirements that must be in place. At the top of this list is securing the necessary protection and supplies for the people working on the front line. As these requirements have not been met, I don’t see my state re-opening any time soon. And being of the “better safe than sorry” philosophy, I am fine with taking whatever time is necessary.

I think one of the aspects of this that we haven’t really even begun to fully realize is the intense trauma of it all. The tactile deprivation, fear over the losses we are facing on a multitude of levels, and the uncertainty over our future direction as a profession and a species. We have been stripped bare and left standing on the abyss of the unknown.

It is a lot to process!

So it is imperative that we find a way to stay grounded, and take care of ourselveseven as our clients must find their way without us. It will require flexibility of mind and spirit — but I think we are up for the challenge and I am incredibly grateful for the sense of community that has been created within our profession as a result of these strange times.

Lynlee Bischoff, LMT
Years in massage: 33
Owner, The Balancing Point
Brownsville, Oregon

I had just opened my own massage studio that caters to athletes. I had just poured my money into my own establishment knowing I had income — and now have no income.

I am doing something different to build up my massage studio. Massage was the forefront of my practice, when this pandemic spread along with fear, I had to again pivot and make personal training the main catalyst. I started training people online, people I had as clients before who still wanted to work out and stay in shape while being at home.

I set up conference calls with personal training clients, and emailed old massage clients checking up on them, which they appreciated. Through those efforts I gained loyal support of people that I feel will help me when I relaunch my massage studio.

When we can get to a point of being somewhat normal, my focus on online personal training will switch to my secondary focus and my massage will again be my driving force. My future will be different as I understand the relationship personal training and massage have with each other. I know that for me both are a must for me to perform the best job I can on clients.

I feel that the massage business will change; there will be people fearful of getting a massage. Those who realize the benefits of a massage for pain management or soreness and stiffness from working out at home all this time will embrace massage.

I would like to add to all massage therapists, I hope you all took this time to work on you. I do not think I know a massage therapist that does not hurt from repetitive motion, long hours, poor body mechanics or something.

We could have looked at this situation as something very terrible or looked at it as a chance for us to recharge our batteries, get in better shape, remember why we are in this profession, learn something new, and include self-care into our daily lives.

When you do relaunch work, be grateful of those clients you had and tell them that you appreciate them. Little things go a long way.

Daric Bass, LMT
Years in massage: 7
Owner, personal trainer, nutrition coach, Health Performance Plus
Metairie, Louisiana